Opinion: From Litzman to German

When a new health minister takes over the little-coveted portfolio this week, it
will probably be the first time in the state’s history that the outgoing
minister won’t shake hands with his successor.

Deputy Health Minister
Ya’acov Litzman – who was the actual head of the ministry even though Prime
Minister Binyamin Netanyahu was formally responsible for it – won’t shake the
hand of former Herzliya mayor Yael German, not because of any personal hostility
to her; the reason is that he is an ultra-Orthodox United Torah Judaism MK and
she is a woman.

The two are almost perfect opposites.

Litzman, who
in the past half year has said publicly so many times that he wants to keep the
portfolio that he actually persuaded himself he would, is fuming over the fact
that he will not be deputy minister again and that there will be no haredi MKs
in the new government. These were among the reasons behind his extreme, and
false, statement on Wednesday that the new government “hates religion,” despite
the many believers and crocheted kippot in the coalition.

Litzman devoted
many hours a day to the job, and deserves an “E” for effort. But while his
public image is, on balance, positive, health experts call into question whether
he was the “excellent health minister” that Netanyahu has called him, or even
“very good.”

Of the more than 100 leading personalities in the health
system, medical faculties and others, very few would say privately that he
deserved top marks, even though some of them said both publicly and to his face
that he excelled.

Netanyahu was formally health minister because UTJ
refuses to have ministers who would be collectively responsible for Shabbat
desecrations and other phenomenon they object to; a deputy minister does not sit
in the cabinet and thus is formally not responsible.

German, a
57-year-old Haifa born wife and mother of two, with a bachelor’s degree in
history, a master’s in business administration and a teacher’s certificate, has
dedicated herself to Herzliya municipal affairs and the city council, served as
manager of a political consulting firm, headed a school for adult education –
and was formerly associated with the Meretz party. She will be the first female
health minister since Labor’s Shoshana Arbeli-Almoslino, who served from 1986 to
1988.

Litzman, born in Germany to Holocaust survivors and brought to
Brooklyn as a young child, went to a haredi yeshiva that taught mostly Torah and
Talmud rather than a religious high school that included a broad secular
curriculum as well. He came on aliya at the age of 18 and went to a higher
yeshiva.

After the Rabbi of Gur advised him to enter politics, he was
elected to the Knesset and served more than once as chairman of the Finance
Committee, where he used his expertise in finance. In 2009, he fell in love with
the Health Ministry and vowed to reform it, but he proved to be a highly
sectorial deputy minister.

He lost the first director-general he
appointed, Dr. Eitan Hai-Am, who resigned when Litzman fought to delay the
construction of the muchneeded fortified, partially underground emergency
department at Ashkelon’s Barzilai Medical Center.

Litzman claimed that
bones found at the site, which were identified by archeologists as being of
pagans due to non- Jewish symbols found in the graves, belonged to Jews. Hai- Am
argued that any more construction delays could endanger lives of patients,
staffers and visitors in bombing attacks from Gaza terrorists.

The
government later forced Litzman to go ahead with building at the site, and Hai-
Am went to work as director general of the Herzliya Medical Center and since then
at a medical center in Vietnam.

Litzman also aroused ire for siding with
a haredi mother with Munchausen’s-by-proxy syndrome who nearly starved her baby
boy. Litzman sided with her and had no praise for Hadassah Medical Center for
identifying the cause for the child’s failure to thrive, even though it was
clear the mother had prevented the child from eating, for which she was jailed.
The deputy minister also ordered that a haredi girl with lower-brain death
continue to be treated in an intensive care bed until her heart stopped a few
days later.

When Litzman was Finance Committee chairman, he succumbed to
Treasury pressure and pushed the privatization of the School Health Service
through the Knesset. This service was well run by public health nurses, who were
fired and replaced by nurses working in private companies who were supposed to
vaccinate all children, perform regular health checks and educate pupils about
health. The state comptroller has since written severe reports on the private
companies’ functioning, and while the Finance Ministry claims the privatization
would save a few tens of millions of shekels a year, it has cost more when
public nurses were used.

Litzman saw that the privatization caused severe
problems and agreed to return the public nurses in the South, where the problems
were most severe, but he never admitted his error, and most schools continue to
have the inferior private services.

He also failed to encourage organ
donation because of his party’s opposition to taking lifesaving organs from
brain-dead patients, and he even asked Hai-Am to give him a flu shot in front on
cameras so a female nurse wouldn’t be seen touching him.

His cancellation
of parental fees for well-baby (tipat halav) services was well advised, as the
health system should encourage families to have their children’s health checked
and undergo vaccinations, while charging for the service discourages them to do
so.

Litzman pressed for giving basic dental care to children as part of
the basket of health services, which was especially welcomed by large families
who could not afford dental treatment. But public health experts argue that the
money could have been better spent on teaching haredi parents how to prevent
dental caries by avoiding sweets showered on children, especially for Shabbat
and holidays.

In addition, Litzman arranged for only the four public
health funds’ subsidiaries or contracted dental companies to provide basic care,
never getting private pediatric dentists on board to earn enough to make it
worthwhile.

Some of them have even gone bankrupt or left the country as a
result. Litzman declined to allow independent academic research on whether the
dental program met its aims and was run efficiently, or whether there was
over treatment or other abuses.

The UTJ MK changed his mind about the
psychiatric care reform that would give responsibility for such care tp the
health funds instead of the ministry. Aware of very long queues for treatment,
especially for children, he agreed to the reform, but it is still far from fully
implemented.

He also changed his mind about licensing MRI scans and not
limiting them (demanded by the Treasury because more MRIs means increasing
health costs). Licenses are more freely issued by the ministry, but it is still
the hospitals that must purchase them.

His plans for the government to
supply basic state provided geriatric nursing care in exchange for an increase in
health taxes were widely praised, but opposition by the Treasury could stymie
the reform that Litzman hoped to implement in a second term.

Litzman was
weak on public health and promoted few initiatives in disease prevention and
health promotion, even though this aspect is increasingly being regarded as key
to reducing the huge costs of treating chronic diseases.

The long
doctors’ strike ended with concessions to young physicians who want higher pay,
and generous incentives for those willing to work in the periphery. But now the
Treasury, which negotiated the agreement with the Israel Medical Association,
wants to tax the incentives and thus weaken readiness to leave the
Center.

Much-needed physicians continue to leave the country, work
privately or switch to more lucrative professions.

Litzman added a few
hundred funded hospital beds around the country, but the number of beds still
lags sorely behind population growth, and the need for more nurses and doctors
continues to lengthen queues in clinics and cause crowding in the
hospitals.

Out-of-pocket fees for medications and certain services
continue to burden the public, thus increasing the gaps between rich and
poor.

German will take over Litzman’s office on the 13th floor of the new
complex behind Jerusalem’s central bus station and find a still-troubled
ministry that almost no one wants to run, despite a NIS 20 billion annual budget
(the third highest in the government) and its major influence on the lives of
every citizen.

As the healthcare field has become increasingly feminized
– not only with the presence of female nurses but with the growing number of
women as professors, researchers, physicians and paramedics – having a woman
minister is a fitting result of the elections after a quarter of a century of
men running the ministry.

German will have her hands full, but as an
ear-to-the-ground mayor whose responsibility included health issues in her city
and as a woman who naturally feels compassion for the sick and suffering, she
has the potential of doing a splendid job.

Your comment must be approved by a moderator before being published on JPost.com.
Disqus users can post comments automatically.

Comments must adhere to our Talkback policy. If you believe that a comment has breached the Talkback policy, please press the flag icon to bring it to the attention of our moderation team.